Free-breathing steady-state free precession cine cardiac magnetic resonance with respiratory navigator gating.

Abstract

To develop and validate a respiratory motion compensation method for free-breathing cardiac cine imaging. A free-breathing navigator-gated cine steady-state free precession acquisition (Cine-Nav) was developed which preserves the equilibrium state of the net magnetization vector, maintains the high spatial and temporal resolutions of standard breath-hold (BH) acquisition, and images entire cardiac cycle. Cine image data is accepted only from cardiac cycles occurring entirely during end-expiration. Prospective validation was performed in 10 patients by obtaining in each three complete ventricular image stacks with different respiratory motion compensation approaches: (1) BH, (2) free-breathing with 3 signal averages (3AVG), and (3) free-breathing with Cine-Nav. The subjective image quality score (1 = worst, 4 = best) for Cine-Nav (3.8 ± 0.4) was significantly better than for 3AVG (2.2 ± 0.5, P = 0.002), and similar to BH (4.0 ± 0.0, P = 0.13). The blood-to-myocardium contrast ratio for Cine-Nav (6.3 ± 1.5) was similar to BH (5.9 ± 1.6, P = 0.52) and to 3AVG (5.6 ± 2.5, P = 0.43). There were no significant differences between Cine-Nav and BH for the ventricular volumes and mass. In contrast, there were significant differences between 3AVG and BH in all of these measurements but right ventricular mass. Free-breathing cine imaging with Cine-Nav yielded comparable image quality and ventricular measurements to BH, and was superior to 3AVG.